Nicorandil associated pinna ulceration: a new entity for an otolaryngologist.

Nicorandil induced ulceration is a phenomenon that is becoming increasingly recognised in clinical practice. However, most cases of Nicorandil induced ulcers appear at the muco-cutaneous interface zones. We report a case of Pinna ulceration where Nicorandil appeared to be the chief aetiological factor. Having ruled out all reasonable alternatives Nicorandil treatment was discontinued and a rapid improvement in the ulcer was observed. To the best of our knowledge this is the first recorded case of external ear ulceration related to Nicorandil use.

Benefits of music on theatre staff in a paediatric theatre setting: a staff survey.

BACKGROUND: Music has a long-standing place in the operating theatre. Nonetheless, limited studies have investigated the role of music during Ear Nose and Throat (ENT) surgical procedures. AIMS: To evaluate the benefits of background music on ENT theatre staff. METHODS: A 10-question survey was distributed to ENT theatre staff over a four week period. RESULTS: A total of 36 ENT theatre staff responded to the survey, a response rate of 86%. Most participants (61%) enjoyed the calming effect of background music in ENT surgery. The majority of participants responded that music did not affect their communication with other staff (69%), and improved their concentration (61%). Most respondents agreed that music can produce a sense of comfort for the patients (69%), and reduce anxiety before anaesthesia (75%). CONCLUSIONS: Background music can have a calming effect on staff in paediatric elective ENT surgery. This is a decision to be made by the surgical team with direct patient care and, if there is any concern about communication and distraction, then it is to be avoided.

Unusual Presentation of Pott's puffy tumour in a child: our recent experience and review of the literature.

Pott's puffy tumour (PPT) is a rarely seen, but highly important, complication of frontal sinusitis. Early recognition followed by prompt imaging and treatment of this condition are essential to improve patient outcomes and prevent complications. This case report describes an atypical presentation of radiologically confirmed PPT in a boy who presented with a 2.5-week history of progressive frontal headache and midline frontal swelling. Flexible nasendoscopy revealed no acute findings. Prompt CT imaging confirmed the diagnosis and early surgical intervention via endoscopic approach with aggressive antibiotic therapy led to good recovery. This case highlights the need to remember PPT in assessing any child or adolescent with a new forehead swelling, with or without sinusitis symptoms. If there is strong clinical suspicion, further imaging should not be delayed. Surgical intervention should be performed as early as possible to prevent intracranial complications; antibiotics alone are not sufficient.